Blue Shadows Treatment with Eyelid Surgery?

Can anything be done at the same time with eyelid surgery for "blue" shadows under the eyes? It looks as if the veins are almost on the surface of the skin.

Doctor Answers 5

Blue shadows under the eyes can be due to genetics or allergies.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The blue shadows that are underneath the eyelids can be genetic, or related to allergies. Very thin, translucent skin will show blood vessels underneath the skin. Make sure your allergies are under control and on a low-salt diet, as these can increase puffiness. Bags under the eyes can be removed through a transconjunctival lower lid blepharoplasty.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Blepharoplasty, dark lower eyelid skin, under eye hollows

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Csd323

The dark color under the eyes is very difficult to correct completely. It is caused by the thin skin - the muscle being visible thru the skin, existing pigmentation in the skin and the blood vessels that are visible thru the skin. Also, the region under the eye has a loss of volume with age- this creates a hollow in which there is a shadow in certain light- thus dark color as well.

Filliing the hollow with micro fat grafting works extremely well to correct the hollow. The other components of the color may be assisted surgically. Laser and chemical peels have less effect on making color change.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Blue Lower Lids and Blepharoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Blue or dark lower eyelids are due to thin skin over veins or muscle. The key to treatment is removal of the veins, adding product to the subcutaneous space and treating the skin.

If the veins are large cautery may be necessary. If they are small than laser ablation or IPL may be necessay. Treatment of the skin to increase thickness could include laser resurfacing, peels and tretinoin.

For the subcutaneous space micro fat grafting would be helpful.

IPL combined with arcus release and fat grafting is best for blue circles under eyes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Very specific procedures are required to correct blue circles under the eyes. Thin skin and visible veins are part of the problem. Some lasers and IPL (intense Pulsed light) treatments can help remove pigment and close many of the small blood vessels.

Many patients with dark circles also have a depression beneath the lower eyelid which creates a shadow and makes the dark circles worse. To plump the depression and improve the dark circle i dpo a procedure which involves placing a fat graft beneath the lower eyelid to plump the depression.

I use a composite fat graft NOT FAT INJECTION. Fat injection often has to be repeated and can create lumps.

Treatment for dark shadows under eyes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Blue shadows are common at the lower eyelid skin. The skin in this area is very thin, so underlying structures such as veins and orbital muscles may be visible through the skin. Surgically, there is no ideal solution for the problem. Carbon dioxide laser resurfacing can improve the texture and tone of the skin, but won't do much for the blue color. If the dark shadows under the eyes are due to excess brown pigmentation, laser resurfacing or certain prescription bleaching regimens may help (Obagi NuDerm skin care or TriLuma cream). If there is a substantial amount of protruding fat causing bulges at the lower lids, there may be dark shadowing below the bulges. In that case a lower lid blepharoplasty may be helpful. But if the problem is simply due to thin, translucent skin, the best treatment may be cool compresses to shrink swelling, control of nasal/sinus allergies which may exacerbate swelling, along with some salt restriction to lessen retention of water in the delicate tissues around the eyes.

Pamela B. Rosen, MD
Coral Springs Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.